Assessment of Survivin and Lactate Dehydrogenase Isoenzyme in Leukemic Egyptian Patients

Abstract

Accurate diagnosis and proper monitoring of cancer patients remain important obstacles for successful cancer treatment. The search for cancer biomarkers is carried out in order to quickly identify tumor cells and predict treatment response, ultimately leading to a favorable therapeutic outcome. The goal of this study is to highlight the importance of survivin level in cases of acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CLL) to find its possible role in the pathophysiological development of the disease. Also to assess the oxidative stress in leukemic patients and to elucidate the relationship between erythrocytes lactate dehydrogenase (LDH) isoenzymes, antioxidant status, and survivin protein expression. This was achieved by detection the survivin-positive lymphocyte, erythrocyte glutathione peroxidase (E-GP-x), both of vitamin E and C, erythrocyte and serum LDH isoenzymes levels, and malondialdehyde (MDA). This study included 40 patients divided into two groups: 20 patients with CLL and 20 patients with ALL, together with 20 healthy control subjects (two groups age matched). The study showed a significant elevation in serum survivin protein, total LDH and MDA levels in patients with acute and chronic leukemia in comparison to healthy subjects. In contrast, vitamin C levels were decreased significantly in both studied groups. Strong correlation between survivin-positive lymphocyte and MDA was evident in ALL and CLL patients in the other hand a significant negative correlation between survivin and vitamin C in ALL patients was observed. A highly significant increase in serum levels of LDH isoenzymes commonly recorded in ALL patients with significant increase in LDH 1, LDH3, LDH4, and LDH5 in CLL group. Also erythrocytes LDH 4 and LDH5 show a highly significant increase and highly significant decrease in LDH2 in both studied groups. These data suggest that survive may be associated with the development of acute and chronic leukemia.